EP2605769A2 - Benzochinonderivate als modulatoren der mitochondrienfunktion - Google Patents

Benzochinonderivate als modulatoren der mitochondrienfunktion

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Publication number
EP2605769A2
EP2605769A2 EP11748898.1A EP11748898A EP2605769A2 EP 2605769 A2 EP2605769 A2 EP 2605769A2 EP 11748898 A EP11748898 A EP 11748898A EP 2605769 A2 EP2605769 A2 EP 2605769A2
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EP
European Patent Office
Prior art keywords
compound
mitochondrial
group
formula
encephalomyopathy
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EP11748898.1A
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English (en)
French (fr)
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EP2605769B1 (de
Inventor
Achim Feurer
Nuri Gueven
Barbara Hoffmann-Enger
Michael Erb
Holger Deppe
Robert Dallmann
Roman Haefeli
Fabrice Heitz
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Santhera Pharmaceuticals Schweiz GmbH
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Santhera Pharmaceuticals Schweiz GmbH
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Priority to RS20160776A priority Critical patent/RS55173B1/sr
Priority to EP11748898.1A priority patent/EP2605769B1/de
Priority to SI201130942A priority patent/SI2605769T1/sl
Publication of EP2605769A2 publication Critical patent/EP2605769A2/de
Application granted granted Critical
Publication of EP2605769B1 publication Critical patent/EP2605769B1/de
Priority to SM201600345T priority patent/SMT201600345B/it
Priority to CY20161101059T priority patent/CY1118134T1/el
Priority to HRP20161407TT priority patent/HRP20161407T1/hr
Active legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/12—Ketones
    • A61K31/122—Ketones having the oxygen directly attached to a ring, e.g. quinones, vitamin K1, anthralin
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
    • C07C50/00—Quinones
    • C07C50/26—Quinones containing groups having oxygen atoms singly bound to carbon atoms
    • C07C50/28—Quinones containing groups having oxygen atoms singly bound to carbon atoms with monocyclic quinoid structure

Definitions

  • the present invention relates to benzoquinone derivatives which are efficient as modulators of mitochondrial function and as such are useful for the treatment of pathological conditions where mitochondrial function is impaired.
  • Mitochondria sometimes described as "cellular power plants” because they generate most of the cell's supply of adenosine triphosphate (ATP), are essential to eukaryotic life.
  • mitochondria are also involved in a range of other processes, such as signalling, cellular differentiation, cell death, as well as the control of the cell cycle and cell growth.
  • Mitochondria have been implicated in several human diseases, including mitochondrial disorders and cardiac dysfunction and may play a role in the aging process.
  • mitochondrial dysfunction is an important factor in a wide range of human diseases.
  • Chrysostomou et al. (Chrysostomou V, Trounce IA, Crowston JG. Ophthalmic Res. 2010;44(3): 173-8 suggested that mitochondrial dysfunction, inherited or as a cause or consequence of injury, renders ocular cells (in particular retinal ganglion cells) sensitive to degeneration.
  • Therapeutic approaches that target mitochondria should therefore provide a general means of protecting lens and retinal ganglion cells from degeneration, regardless of the etiology of the disease.
  • ophthalmological indications such as Leber's hereditary optic neuropathy (LHON), autosomal dominant optic atrophy (DOA), or ophtalmological indications displaying mitochondrial dysfunction such as macular degeneration, glaucoma, retinopathy, cataract, optic disc drusen (ODD).
  • LHON Leber's hereditary optic neuropathy
  • DOA autosomal dominant optic atrophy
  • ODD optic disc drusen
  • mitochondrial-neurodegenerative disorders that might not be ophthalmological diseases per se, such as MELAS (mitochondrial myopathy, encephalomyopathy, lactic acidosis, stroke-like symptoms), MERFF (myoclonic epilepsy with ragged red fibers), MNGIE (myoneurogenic gastrointestinal encephalomyopathy), Kearns-Sayre syndrome, CoQ10 deficiency, or mitochondrial complex deficiencies (i.e. complex I, II, III, IV, V deficiency, and CPEO) can well exhibit an ophthalmological component among their various symptoms and are thus falling as well under the scope of the above mentioned diseases associated with impaired mitochondrial funtion.
  • MELAS mitochondrial myopathy, encephalomyopathy, lactic acidosis, stroke-like symptoms
  • MERFF myoclonic epilepsy with ragged red fibers
  • MNGIE myoneurogenic gastrointestinal encephalomyopathy
  • Kearns-Sayre syndrome i.e
  • mitochondrial disorders often present as neurological disorders, but also manifest as multi-system disorders, including myopathy, diabetes, multiple endocrinopathy, or a variety of other systemic manifestations. These disorders can be caused by mutations of mitochondrial DNA, by mutations of nuclear genes directly coding for oxidative phosphorylation enzymes and by defects in nuclear genes that are generally important for mitochondrial function. Environmental influences may also interact with hereditary predispositions and cause mitochondrial disease. For example, there is a strong link between pesticide exposure and the later onset of Parkinson's disease. Numerous other pathologies involving mitochondrial dysfunction include schizophrenia, bipolar disorder epilepsy, stroke and autism (Jou et al. Chang Gung Med J.
  • Multiple sclerosis is the most common non-traumatic neurological disease in young adults, with a prevalence of 1 : 1000 in Northern Europe and North-America (Compston A Int MS J .2003. 10:29-31 ).
  • the disease course is generally episodic; exacerbations are followed by periods of remission which are characterized by focal infiltration of leukocytes and demyelination in the white matter.
  • the disease becomes more progressive, where demyelination of the grey matter and axonal degeneration in the white matter become more prominent (Hafler DA J. Clin. Invest. 2004; 1 13:788-794).
  • Available therapies are mainly immunomodulatory, which are effective in reducing the number of relapses. Disease progression, however, remains unchanged by these therapies (Filippini G et al. Lancet 2003; 361 :545-552), demonstrating the need for novel therapeutic strategies oriented towards neuroprotection.
  • WO- A-2006130775 describes an attempt to treat or suppress mitochondrial diseases by modulating energy biomarkers such as lactic acid levels, levels of NAD, NADP, NADH and NADPH, and cytochrome C parameters.
  • energy biomarkers such as lactic acid levels, levels of NAD, NADP, NADH and NADPH, and cytochrome C parameters.
  • the compounds disclosed in the application have been tested for their ability to rescue human dermal fibroblasts from FRDA patients from oxidative stress. However, the data are not represented in the application.
  • benzoquinone derivatives according to formula (I) shown below provide a solution to the object of the present invention.
  • the present invention relates to benzoquinone derivatives according to formula (I)
  • R 1 , R 2 , R 3 and R 4 are defined as below for use in the treatment of disorders wherein mitochondrial function is impaired.
  • the benzoquinone derivatives of formula (I) are particularly useful in the treatment of psychiatric disorders, metabolic disorders, mitochondrial diseases, cancer, multiple sclerosis, primary progressive multiple sclerosis, or immune dysfunctions.
  • the metabolic disorders are selected from ageing-related physical decline, obesity, overweight, type II diabetes, and metabolic syndrome.
  • the psychiatric disorders are selected from schizophrenia, major depressive disorder, bipolar disorder, and epilepsy.
  • the mitochondrial diseases are selected from Leber's hereditary optic neuropathy (LHON), autosomal dominant optic atrophy (DOA), macular degeneration, glaucoma, retinopathy, cataract, optic disc drusen (ODD), mitochondrial myopathy, encephalomyopathy, lactic acidosis, stroke-like symptoms (MELAS), myoclonic epilepsy with ragged red fibers (MERRF), myoneurogenic gastrointestinal encephalomyopathy (MNGIE), Kearns-Sayre syndrome, CoQ10 deficiency, or mitochondrial complex deficiencies.
  • LHON Leber's hereditary optic neuropathy
  • DOA autosomal dominant optic atrophy
  • macular degeneration glaucoma
  • ODD optic disc drusen
  • mitochondrial myopathy encephalomyopathy
  • lactic acidosis lactic acidosis
  • MELAS myoclonic epilepsy with ragged red fibers
  • MNGIE myoneurogenic gastrointestinal encephalomyopathy
  • the mitochondrial diseases are selected from Leber's hereditary optic neuropathy (LHON), autosomal dominant optic atrophy (DOA), macular degeneration, glaucoma, retinopathy, cataract, optic disc drusen (ODD), mitochondrial myopathy, encephalomyopathy, lactic acidosis, stroke-like symptoms (MELAS), myoclonic epilepsy with ragged red fibers (MERRF), myoneurogenic gastrointestinal encephalomyopathy (MNGIE), Kearns-Sayre syndrome, CoQ10 deficiency, or mitochondrial complex deficiencies (1-5, CPEO).
  • LHON Leber's hereditary optic neuropathy
  • DOA autosomal dominant optic atrophy
  • macular degeneration glaucoma
  • ODD optic disc drusen
  • mitochondrial myopathy encephalomyopathy
  • lactic acidosis lactic acidosis
  • MELAS myoclonic epilepsy with ragged red fibers
  • MNGIE myoneurogenic gastrointestinal
  • the immune dysfunctions are selected from arthritis, psoriasis and rheumatoid arthritis.
  • the present invention further relates to a method for treating disorders wherein mitochondrial function impaired, the method comprising administering an effective amount of a compound according to formula (I) to a subject in need thereof.
  • the subject is a mammal, more preferably a human.
  • Figure 1 shows the protective effect of compound IA in RGC-5 cells as in vitro model of mitochondrial dysfunction in ophtalmological cells, 1 day after rotenone challenge.
  • Figure 3 shows the effect of compound IA pre-treatment on visual acuity in an in vivo mouse model for eye disorders characterized by mitochondrial dysfunction.
  • the present invention relates to a compound represented by the following formula
  • a mitochondrial disease selected from the group consisting of Leber's hereditary optic neuropathy (LHON), autosomal dominant optic atrophy (DOA), macular degeneration, glaucoma, retinopathy, cataract, optic disc drusen (ODD), mitochondrial myopathy, encephalomyopathy, lactic acidosis, stroke-like symptoms (MELAS), myoclonic epilepsy with ragged red fibers (MERRF), myoneurogenic gastrointestinal encephalomyopathy (MNGIE), Kearns-Sayre syndrome, CoQ10 deficiency, or mitochondrial complex deficiencies (1- 5, CPEO).
  • LHON Leber's hereditary optic neuropathy
  • DOA autosomal dominant optic atrophy
  • macular degeneration glaucoma
  • retinopathy cataract
  • ODD optic disc drusen
  • mitochondrial myopathy encephalomyopathy
  • MELAS myoclonic epilepsy with ragged red fibers
  • MNGIE myoneurogenic gastrointestinal ence
  • the compound is idebenone.
  • the mitochondrial disease is selected from the group consisting of Leber's hereditary optic neuropathy (LHON), autosomal dominant optic atrophy (DOA), macular degeneration, glaucoma, mitochondrial myopathy, encephalomyopathy, lactic acidosis, stroke-like symptoms (MELAS), or mitochondrial complex deficiencies (1 -5, CPEO).
  • LHON Leber's hereditary optic neuropathy
  • DOA autosomal dominant optic atrophy
  • macular degeneration glaucoma
  • mitochondrial myopathy mitochondrial myopathy
  • encephalomyopathy lactic acidosis
  • lactic acidosis lactic acidosis
  • stroke-like symptoms MELAS
  • mitochondrial complex deficiencies (1 -5, CPEO
  • the mitochondrial disease is Leber's hereditary optic neuropathy (LHON).
  • the mitochondrial disease is autosomal dominant optic atrophy (DOA).
  • DOA autosomal dominant optic atrophy
  • the mitochondrial disease is macular degeneration.
  • the mitochondrial disease is glaucoma.
  • the mitochondrial disease is retinopathy.
  • the mitochondrial disease is cataract. In other words, the disease is cataract formation.
  • the mitochondrial disease is optic disc drusen (ODD).
  • the mitochondrial disease is mitochondrial myopathy, encephalomyopathy, lactic acidosis, strokelike symptoms (MELAS).
  • the mitochondrial disease is myoclonic epilepsy with ragged red fibers (MERRF).
  • the mitochondrial disease is myoneurogenic gastrointestinal encephalomyopathy (MNGIE).
  • MNGIE myoneurogenic gastrointestinal encephalomyopathy
  • the mitochondrial disease is Kearns-Sayre syndrome.
  • the mitochondrial disease is CoQ10 deficiency.
  • the mitochondrial disease is mitochondrial complex deficiencies (1-5, CPEO).
  • the present invention relates to benzoquinone derivatives according to formula (I)
  • R 1 is a substituent represented by formula (II):
  • R 5 and R 6 are both hydrogen atoms, or
  • R 5 is a hydrogen atom and R 6 is an ethyl group, or
  • R 5 and R 6 are both methyl groups
  • R 2 is a methyl group
  • R 3 is a methoxy group
  • R 4 is a methoxy group
  • R 1 is -(CH 2 ) 10 -OH
  • R 2 is a methyl group
  • R 3 is a methyl group
  • R 4 is a methyl group
  • R 1 is -(CH 2 ) 10 -CH 3)
  • R 2 and R 4 are both a hydroxy group or methoxy group
  • R 3 is a hydrogen atom
  • mitochondrial function is impaired, in particular in the treatment of psychiatric disorders, metabolic disorders, mitochondrial disorders, cancer, multiple sclerosis, primary progressive multiple sclerosis, or immune dysfunctions.
  • the disorder is a psychiatric disorder.
  • the psychiatric disorder is selected from the group consisting of schizophrenia, major depressive disorder, bipolar disorder, and epilepsy.
  • the disorder is a metabolic disorder.
  • the metabolic disorder is selected from the group consisting of ageing-related physical decline, obesity, overweight, type II diabetes and metabolic syndrome.
  • the disorder is a mitochondrial disorder.
  • the mitochondrial disease is selected from the group consisting of Leber's hereditary optic neuropathy (LHON), autosomal dominant optic atrophy (DOA), macular degeneration, glaucoma, retinopathy, cataract, optic disc drusen (ODD), mitochondrial myopathy, encephalomyopathy, lactic acidosis, stroke-like symptoms (MELAS), myoclonic epilepsy with ragged red fibers (MERRF), myoneurogenic gastrointestinal encephalomyopathy (MNGIE), Kearns-Sayre syndrome, CoQ10 deficiency, or mitochondrial complex deficiencies (1-5, CPEO).
  • LHON Leber's hereditary optic neuropathy
  • DOA autosomal dominant optic atrophy
  • macular degeneration glaucoma
  • retinopathy cataract
  • ODD optic disc drusen
  • mitochondrial myopathy encephalomyopathy
  • MELAS myoclonic epilepsy with ragged red fibers
  • MNGIE myoneurogenic gastrointestinal ence
  • the disorder is cancer.
  • the disorder is multiple sclerosis.
  • multiple sclerosis is selected from relapsing remitting multiple sclerosis, secondary progressive multiple sclerosis, and progressive relapsing multiple sclerosis.
  • the disorder is primary progressive multiple sclerosis. In a preferred embodiment in combination with any of the above or below embodiments, the disorder is an immune dysfunction.
  • the immune dysfunction is selected from the group consisting of arthritis, psoriasis and rheumatoid arthritis.
  • the compound is a compound of formula (I), wherein
  • R 1 in formula (I) is a substituent represented by formula (II): wherein
  • R 5 and R 6 are both hydrogen atoms, or
  • R 5 is a hydrogen atom and R 6 is an ethyl group, or
  • R 5 and R 6 are both methyl groups
  • R 2 is a methyl group
  • R 3 is a methoxy group
  • R 4 is a methoxy group.
  • the compound is a compound of formula (I), wherein
  • R 1 is a substituent represented by formula (II):
  • R 5 and R 6 are both hydrogen atoms
  • R 2 is a methyl group
  • R 3 is a methoxy group
  • R 4 is a methoxy group
  • the compound is a compound of formula (I), wherein
  • R 1 in formula (I) is a substituent represented by formula (II):
  • R 5 is a hydrogen atom and R 6 is an ethyl group
  • R 2 is a methyl group
  • R 3 is a methoxy group
  • R 4 is a methoxy group.
  • the compound is a compound of formula (I), wherein
  • R 1 in formula (I) is a substituent represented by formula (II):
  • R 5 and R 6 are both methyl groups
  • R 2 is a methyl group
  • R 3 is a methoxy group
  • R 4 is a methoxy group.
  • the compound is a compound of formula (I), wherein
  • R 1 is -(CH 2 ) 10 -OH
  • R 2 is a methyl group
  • R 3 is a methyl group; and R 4 is a methyl group.
  • the compound is a compound of formula (I), wherein
  • R 1 is -(CH 2 ) 10 -CH 3 ;
  • R 2 and R 4 are both a hydroxy group or methoxy group
  • R 3 is a hydrogen atom.
  • the present invention is directed to the use of a compound represented by the following formula
  • a mitochondrial disease selected from the group consisting of Leber's hereditary optic neuropathy (LHON), autosomal dominant optic atrophy (DOA), macular degeneration, glaucoma, retinopathy, cataract, optic disc drusen (ODD), mitochondrial myopathy, encephalomyopathy, lactic acidosis, stroke-like symptoms (MELAS), myoclonic epilepsy with ragged red fibers (MERRF), myoneurogenic gastrointestinal encephalomyopathy (MNGIE), Kearns-Sayre syndrome, CoQ10 deficiency, or mitochondrial complex deficiencies (1-5, CPEO).
  • LHON Leber's hereditary optic neuropathy
  • DOA autosomal dominant optic atrophy
  • MDA mitochondrial myopathy
  • encephalomyopathy lactic acidosis
  • MELAS myoclonic epilepsy with ragged red fibers
  • MNGIE myoneurogenic gastrointestinal encephalomyopathy
  • Kearns-Sayre syndrome CoQ
  • the present invention is directed to the use of a compound according to general formula (I)
  • R 1 to R 4 are defined as above for the preparation of a medicament in the treatment of psychiatric disorders, metabolic disorders, mitochondrial diseases, cancer, multiple sclerosis, primary progressive multiple sclerosis, or immune dysfunction.
  • R represents formula (II) and R 2 to R 6 are defined as above. More preferably, R 1 represent formula (II) and R 5 and R 6 both represent hydrogen atoms.
  • the compounds of formula (I) are for use in the treatment of psychiatric disorder, metabolic disorders, mitochondrial disorders, cancer, multiple sclerosis, primary progressive multiple sclerosis or immune dysfunction.
  • the compounds of formula (I) are for use in the treatment of cancer or psychiatric disorders selected from schizophrenia, major depressive disorder, bipolar disorder, and epilepsy or metabolic disorders selected from ageing-related physical decline, obesity, overweight, type II diabetes, and metabolic syndrome or immune dysfunctions selected from arthritis, psoriasis or rheumatoid arthritis.
  • the compounds of formula (I) are known compounds and have been previously described.
  • the compound of formula (I) wherein R 1 represents formula (II) with R 5 and R 6 both representing hydrogen atoms is known as Idebenone (in the following referred to as Compound IA).
  • Idebenone in the following referred to as Compound IA.
  • This compound is already used as a nootropic drug and has also been described to stimulate nerve growth factor, a characteristic that could be important in the treatment of Alzheimer's and other neurodegenerative diseases.
  • WO 2006100017 describes the use of Compound IA in the treatment of muscular dystrophies such as Duchenne muscular dystrophy and Becker muscular dystrophy. Compound IA and its preparation are first described in the specification of Japanese Patent Examined Publication No. 3134/1987 filed by Takeda Chemical Industries, Ltd.
  • the compound of formula (I) wherein R 1 is a -(CH 2 )io-OH group and each of R 2 to R 4 represents a methyl group can be considered as an analogue to Idebenone (in the following referred to as Compound ID).
  • Compound ID A general method for the synthesis of benzoquinone compounds such as Compound ID is described in EP-A-0038674. Said patent application also investigates the role of benzoquinone compounds such as Compound ID in the inhibition of the generation and release of SRS-A and contemplates their potential use in the treatment of allergic diseases.
  • the compound of formula (I) wherein R 1 is a -(CH 2 )i 0 -CH 3 group, both of R 2 and R 4 represent a hydroxy group and R 3 is a hydrogen atom (in the following referred to as Compound IE) is also known under the name Embelin as it has been identified primarily from the Embelia ribes plant but is nowadays commercially available through various suppliers. Said compound has been shown to exhibit anti-tumor, anti-inflammatory, and apoptotic activities through an unknown mechanism.
  • Embelin the small molecular inhibitor of XIAP, possesses a wide spectrum of biological activities with strong inhibition of nuclear factor kappa B and downstream antiapoptotic genes but that the mechanism of its cell death induction is not known. Further studies suggest that Embelin can act as a competitive antioxidant in physiological conditions (Chemico-Biological Interactions (2007), 167(2), 125-134).
  • the compound of formula (I) wherein R 1 is a -(CH 2 )io-CH 3 group, both of R 2 and R 4 represent a methoxy group and R 3 is a hydrogen atom is a derivative to Embelin (in the following referred to as Compound IF).
  • a method for the synthesis of Compound IF is, for example, given in Tetrahedron (1998), 54(49), 14791-802.
  • a therapeutic use has not been indicated for Compound IF, however, the compound may possibly show some activity in hepatitis C therapy as can be deduced from a study about the inhibitory effects of plant extracts commonly used in Sudanese traditional medicine on hepatitis C virus protease (Phytotherapy Research (2000), 14(7), 510-6). It was found that two benzoquinone compounds extracted from Embelia schimperi, namely embelin and 5-O-methylembelin, are potent hepatitis C virus protease inhibitors.
  • the compounds according to formula (I) are modulators of mitochondrial disorders and are thus useful in the treatment of mitochondrial diseases in general.
  • Attempts to bypass the strong first-pass effect of idebenone include to administer the compound via routes other than oral.
  • Parenteral formulations are difficult to obtain as idebenone exhibits only very low water solubility.
  • US2010/0130619, US2010/0129431 A1 , US2010/0215725A1 and US2010/0099775 A 1 describe a parenteral formulation of idebenone suitable for intravenous injection or infusion.
  • WO2008/019769 discloses a transmucosal formulation of idebenone to circumvent the strong first-pass effect. Even though this formulation is taken via the mouth, the processing of the drug by the body is completely different compared to the oral administration. In contrast to an oral administration, the transmucosal (e.g. sublingual) formulation of a drug leads to absorption via the mucosa which enables the drug to reach the blood stream even without being processed by the gastro-intestinal tract, and hence, avoids the first-pass effect in the liver.
  • FRDA Field Determinal Optic Neuropathy
  • MELAS mitochondrial myopathy, encephalopathy, lactic acidosis with stroke-like episodes
  • mitochondrial myopathies mitochondrial myopathies.
  • the consequence of avoiding the first-pass effect is that higher concentrations of the drug are circulating in the blood stream and finally that higher concentrations of the drug can be achieved in the tissue relevant for a given disease.
  • a parenteral, e.g. intraveneous administration, of a compound is often considered either not practicable or causing significant nursing cost in the setting of a genetic (and consequently chronic) disease, where patients are home-based and not in a hospital but have to take a drug life-long.
  • a transmucosal formulation might - in particular in the case of compounds of formula (I) - due to their intense colour and potential bad taste also be hampered by a reduced patient compliance.
  • Another way to bypass the strong first-pass effect is to administer the compounds of formula (I) by topical formulation, including dermal, buccal, sublingual and intraocular formulation.
  • the total concentration means idebenone including its metabolites.
  • the correction factor calculated from Torii et al to obtain the levels of the unmetabolized parent compound IA, this results in idebenone plasma levels of 3 ng/ml.
  • the corresponding levels in the brain are 10 ng/ml of total idebenone (which again means including the metabolites), resulting in only 0.03 ng/ml for parent idebenone itself.
  • the ratio of brain vs plasma levels is about 1%. This is in line with the findings of Nagai et al (Nagai Y, Yoshida K, Narumi S, Tanayama S, Nagaoka A.
  • BBB blood brain barrier
  • the eye is usually regarded as part of the central nervous system. This becomes evident in the fact, that, very similar to the blood-brain-barrier, the blood-retinal barrier keeps the retina protected against unwanted diffusion of potentially toxic compounds. Indeed, the blood brain barrier and the blood-retinal barrier are together called the blood-neural barrier (Invest Ophthalmol Vis Sci. 2005 Mar, 46(3), 1047-53: Functional characterization and comparison of the outer blood-retina barrier and the blood brain barrier: Steuer H et al. and Kim, JH et al.).
  • pharmacokinetical data are disclosed demonstrating significant levels of compound IA in vitreous and aqueous humor of the eye after single oral administration.
  • the eye levels of compound IA, obtained after oral administration, are sufficient to cause a significant recovery of visual loss in an animal model (Zhang X., Jones D., Gonzalez-Lima F. Mouse model of optic neuropathy caused by mitochondrial complex I dysfunction. Neurosci. Lett., 2002.) that is relevant for diseases with underlying mitochondrial impairment in the retina.
  • these diseases are ophthalmological mitochondrial diseases such as Leber's hereditary optic neuropathy (LHON), autosomal dominant optic atrophy (DOA), and ophtalmological disorders displaying mitochondrial dysfunction such as macular degeneration, glaucoma, retinopathy, cataract, optic disc drusen (ODD).
  • LHON Leber's hereditary optic neuropathy
  • DOA autosomal dominant optic atrophy
  • ODD optic disc drusen
  • these diseases are genetic neurodegenerative mitochondrial diseases with an ophthalmological component among the various symptoms such as MELAS (mitochondrial myopathy, encephalomyopathy, lactic acidosis, stroke-like symptoms), MERFF (myoclonic epilepsy with ragged red fibers), MNGIE (myoneurogenic gastrointestinal encephalomyopathy), Kearns-Sayre syndrome, CoQ10 deficiency, or mitochondrial complex deficiencies (i.e. complex I, II, III, IV, V deficiency, and CPEO).
  • MELAS mitochondrial myopathy, encephalomyopathy, lactic acidosis, stroke-like symptoms
  • MERFF myoclonic epilepsy with ragged red fibers
  • MNGIE myoneurogenic gastrointestinal encephalomyopathy
  • Kearns-Sayre syndrome i.e. complex I, II, III, IV, V deficiency, and CPEO.
  • the following diseases are designated as a "mitochondrial disease”: Leber's hereditary optic neuropathy (LHON), autosomal dominant optic atrophy (DOA), macular degeneration, glaucoma, retinopathy, cataract, optic disc drusen (ODD), mitochondrial myopathy, encephalomyopathy, lactic acidosis, stroke-like symptoms (MELAS), myoclonic epilepsy with ragged red fibers (MERRF), myoneurogenic gastrointestinal encephalomyopathy (MNGIE), Kearns-Sayre syndrome, CoQ10 deficiency, and mitochondrial complex deficiencies (1-5, CPEO).
  • LHON Leber's hereditary optic neuropathy
  • DOA autosomal dominant optic atrophy
  • macular degeneration glaucoma
  • ODD optic disc drusen
  • mitochondrial myopathy encephalomyopathy
  • lactic acidosis lactic acidosis
  • MELAS myoclonic epilepsy with ragged red fibers
  • Idebenone (compound IA) is known to be a stimulator of neuronal growth factor (NGF) (Takeuchi, R., Murase, K., Furukawa, Y., Furukawa, S., Hayashi, K. Stimulation of nerve growth factor synthesis/secretion by 1 ,4-benzoquinone and its derivatives in cultured mouse astroglial cells. FEBS Lett. 1990, 261 , 63-66).
  • NGF neuronal growth factor
  • Propentophylline is a compound from a completely different compound class and has also been described as stimulator of NGF (Shinoda et al, Stimulation of nerve growth factor synthesis/secretion by propentophylline in cultured mouse astroglial cells, Biochem.
  • the applicants state their compounds may be used orally. This is in accordance with the mechanism of action which - if really building the rational between compounds and disease treatment - does not require the compound itself to build levels in the eye but rather elsewhere in the body to stimluate the production of NGF which then in turn reaches the relevant tissues, e.g. the eye.
  • the present application discloses data showing that propentophylline has no effect on RGC survival when used in an assay that is based on RGCs dying due to complex I inhibition by rotenone, a condition well reflecting the pathology of many of the mitochondrial disorders described above (reviewed by Wong-Riley M., Energy Metabolism of the Visual System, Eye and Brain, 2010, 2 99-116).
  • idebenone compound IA
  • RGC survival assay i.e. based on complex I inhibition.
  • DOA Autosomal dominant optic atrophy
  • OPA1 pathogenic OPA1 mutations cause autosomal dominant optic atrophy, a condition characterized by the preferential loss of retinal ganglion cells and progressive optic nerve degeneration. Approximately 20% of affected patients will also develop more severe neuromuscular complications, an important disease subgroup known as DOA(+). OPA1 was demonstrated to control both mitochondrial fusion and cristae morphology. In addition, OPA1 loss-of -function studies have shown that OPA1 also regulates apoptosis induction (Liesa M et al. Physiol Rev. 2009; 89:799-845).
  • OPA1 Although it is expressed in all the tissues assayed, OPA1 shows a specific tissue expression pattern, with the highest expression in the retina, brain, testis, liver, heart, skeletal muscle, and pancreas. Loss of OPA1 causes a marked reduction in mitochondrial membrane potential and a reduction in basal respiration and incapacity to enhance oxygen consumption in the presence of the uncoupler 2,4-dinitrophenol.
  • Human fibroblasts from patients with certain OPA1 mutations that cause autosomal dominant optic atrophy or ADOA
  • ADOA autosomal dominant optic atrophy
  • the compounds of formula (I) are useful in the treatment of DOA.
  • Mitochondrial diseases also encompass various disorders of the human optic systems such as macular degeneration, glaucoma, retinopathy, cataract, optic disc drusen (ODD).
  • macular degeneration glaucoma
  • retinopathy cataract
  • optic disc drusen ODD
  • AMD age-related macular degeneration
  • VD inherited macular degeneration
  • AMD a medical condition which results in a loss of vision in the center of the visual field (the macula) because of damage to the retina.
  • Glaucoma is a disease in which the optic nerve is damaged, leading to progressive, irreversible loss of vision, which is often, but not always, associated with increased pressure of the fluid in the eye.
  • the nerve damage involves loss of retinal ganglion cells in a characteristic pattern.
  • Raised intraocular pressure is a significant risk factor for developing glaucoma. Untreated glaucoma leads to permanent damage of the optic nerve and resultant visual field loss, which can progress to blindness.
  • Retinopathy is a general term that refers to some form of non-inflammatory damage to the retina of the eye.
  • spontaneous forms can be induced by drugs, toxins and radiation (ionizing and ultra violet).
  • retinopathies are ocular manifestations of systemic diseases such as diabetes, hypertension, sickle cell disease or ciliopathy such as Bardet-Biedl syndrome. Similar to macular degeneration and glaucoma, mitochondrial involvement in retinopathy has been well described (reviewed by Jarrett SG, Lewin AS, Boulton ME. Ophthalmic Res.
  • a cataract is a clouding that develops in the crystalline lens of the eye or in its envelope, varying in degree from slight to complete opacity and obstructing the passage of light.
  • the gradual yellowing and opacification of the lens may reduce the perception of blue colours.
  • Cataracts typically progress slowly to cause vision loss and are potentially blinding if untreated.
  • the condition usually affects both the eyes, but similar to the pathology of LHON and VD, one eye is almost always affected earlier than the other.
  • mitochondrial involvement in cataract formation is clearly described.
  • cataract formation is directly associated with some mitochondrial disorders such as dominant optic atrophy with cataracts, autosomal dominant progressive external ophthalmoplegia (PEOA3), PEOA2, mitochondrial myopathy caused by mutations of COX II or various others genes, Sengers syndrome, as well as mutations of mitochondrial genes such as mitochondrial tRNA-Ser (MTTS2), GFER, OPA3 but also large mitochondrial deletions.
  • mitochondrial disorders such as dominant optic atrophy with cataracts, autosomal dominant progressive external ophthalmoplegia (PEOA3), PEOA2, mitochondrial myopathy caused by mutations of COX II or various others genes, Sengers syndrome, as well as mutations of mitochondrial genes such as mitochondrial tRNA-Ser (MTTS2), GFER, OPA3 but also large mitochondrial deletions.
  • Optic disc drusen or optic nerve head drusen (ONHD) are globules of mucoproteins and mucopolysaccharides that progressively calcify in the optic disc. They are thought to be the remnants of the axonal transport system of degenerated retinal ganglion cells. ODD have also been referred to as congenitally elevated or anomalous discs, pseudopapilledema, pseudoneuritis, buried disc drusen, and disc hyaline bodies. They are associated with vision loss of varying degree occasionally resulting in blindness. Mitochondrial impairment due to Ca 2+ overload has been suggested in the process of drusen formation (Tso MO. Ophthalmology.
  • haplotype J mitochondrial haplotype J
  • haplotype H was associated with significantly lower risk
  • Chrysostomou et al. (Chrysostomou V, Trounce IA, Crowston JG. Ophthalmic Res. 2010;44(3): 173-8) suggested that mitochondrial dysfunction, inherited or as a cause or consequence of injury, renders ocular cells (in particular retinal ganglion cells) sensitive to degeneration.
  • Therapeutic approaches that target mitochondria should therefore provide a general means of protecting lens and retinal ganglion cells from degeneration, regardless of the etiology of the disease.
  • the compounds of formula (I) are also useful for treating psychiatric disorders, metabolic disorders, cancer, multiple sclerosis, primary progressive multiple sclerosis, or immune dysfunction, as will be detailed in the following.
  • the compounds of formula (I) have an effect on body weight gain, possibly due to an effect on ATP production, which could be demonstrated in vitro.
  • the compounds of formula (I) show a beneficial effect in the treatment of diabetes type II, obesity and metabolic syndrome.
  • the compounds of formula (I) are also useful in the treatment of arthritis, psoriasis, sepsis, allergy and microbial infections.
  • RR-MS relapsing-remitting form of the disease
  • PP-MS primary progressive MS
  • PP-MS primary progressive MS
  • RR-MS patients differ from RR-MS patients in several important characteristics: They tend to be older at the time of disease onset (mean 40 vs. 30 years); males and females tend to be affected equally; clinically there is a high prevalence of cortico-spinal dysfunction characterized by progressive weakness and spasticity; patients have more prominent involvement of the spinal cord and generally lower amount of distinct white matter lesions (i.e. plaques) in the brain and less evidence for brain inflammatory activity and, most importantly, PP-MS patients do not respond to immunomodulatory therapies with proven efficacy in RR-MS. Both new imaging modalities and pathological data suggest that in PP-MS, CNS pathology is more diffuse and occurs to some extent independently of focal lesions.
  • salts refers to salts prepared from pharmaceutically acceptable non-toxic bases or acids including inorganic or organic bases and inorganic or organic acids.
  • Salts derived from inorganic bases include aluminum, ammonium, calcium, copper, ferric, ferrous, lithium, magnesium, manganic salts, manganous, potassium, sodium, zinc and the like. Particularly preferred are the ammonium, calcium, lithium, magnesium, potassium and sodium salts.
  • Salts derived from pharmaceutically acceptable organic non-toxic bases include salts of primary, secondary and tertiary amines, substituted amines including naturally occurring substituted amines, cyclic amines and basic ion exchange resins, such as arginine, betaine, caffeine, choline, ⁇ , ⁇ '-dibenzylethylenediamine, diethylamine, 2- diethylaminoethanol, 2-dimethylamino-ethanol, ' ethanolamine, ethylenediamine, N- ethylmorpholine, N-ethylpiperidine, glucamine, glucosamine, histidine, hydrabamine, isopropylamine, lysine, methylglucamine, morpholine, piperazine, piperidine, polyamine resins, procaine, purines, theobromine, triethylamine, trimethylamine, tripropylamine, tromethamine and the like.
  • basic ion exchange resins such
  • salts may be prepared from pharmaceutically acceptable non-toxic acids, including inorganic and organic acids.
  • acids include acetic, benzenesulfonic, benzoic, camphorsulfonic, citric, ethanesulfonic, formic, furnaric, gluconic, glutamic, hydrobromic, hydrochloric, isethionic, lactic, maleic, malic, mandelic, methanesulfonic, malonic, mucic, nitric, parnoic, pantothenic, phosphoric, propionic, succinic, sulfuric, tartaric, p-toluenesulfonic, trifluoroacetic acid and the like.
  • Particularly preferred are citric, furnaric, hydrobromic, hydrochloric, maleic, phosphoric, sulfuric and tartaric acids.
  • the compounds of formula (I) are preferably formulated into a dosage form prior to administration. Accordingly the present invention also includes a pharmaceutical composition comprising a compound of formula (I) or a pharmaceutically acceptable salt or solvate thereof and a suitable pharmaceutical carrier.
  • the carrier(s) must be "acceptable” in the sense of being compatible with the other ingredients of the composition and not deleterious to the recipient thereof. Proper formulation is dependent upon the route of administration chosen. Any of the well-known techniques, carriers, and excipients may be used as suitable and as understood in the art; e.g., in Remington's Pharmaceutical Sciences.
  • the pharmaceutical compositions of the present invention may be manufactured in a manner that is itself known, e.g., by means of conventional mixing, dissolving, granulating, dragee-making, levigating, emulsifying, encapsulating, entrapping or compression processes.
  • Any suitable route of administration may be employed for providing a mammal, especially a human with an effective dosage of a compound of formula (I).
  • Suitable administration routes include oral, parenteral (including subcutaneous, intradermal, intramuscular, intravenous, intraarticular, and intramedullary), intraperitoneal, transmucosal, transdermal, rectal and topical (including dermal, buccal, sublingual and intraocular) administration although the most suitable route may depend upon for example the condition and disorder of the recipient.
  • the administration route is oral.
  • the administration route is topical ocular.
  • the administration route is an intraocular injection.
  • the administration route is an intraocular depot implant.
  • the formulations may conveniently be presented in unit dosage form and may be prepared by any of the methods well known in the art of pharmacy. All methods include the step of bringing into association a compound of the present invention or a pharmaceutically acceptable salt or solvate thereof ("active ingredient") with the carrier which constitutes one or more accessory ingredients. In general, the formulations are prepared by uniformly and intimately bringing into association the active ingredient with liquid carriers or finely divided solid carriers or both and then, if necessary, shaping the product into the desired formulation.
  • Formulations of the present invention suitable for oral administration may be presented as discrete units such as capsules, cachets or tablets each containing a predetermined amount of the active ingredient.
  • the active ingredient may further be presented as a powder or granules; as a solution or a suspension in an aqueous liquid or a non-aqueous liquid; or as an oil-in-water liquid emulsion or a water-in-oil liquid emulsion.
  • the active ingredient may also be presented as a bolus, electuary or paste.
  • compositions which can be used orally include tablets, push-fit capsules made of gelatin, as well as soft, sealed capsules made of gelatin and a plasticizer, such as glycerol or sorbitol. Tablets may be made by compression or molding, optionally with one or more accessory ingredients. Compressed tablets may be prepared by compressing in a suitable machine the active ingredient in a free-flowing form such as a powder or granules, optionally mixed with binders, inert diluents, or lubricating, surface active or dispersing agents. Molded tablets may be made by molding in a suitable machine a mixture of the the powdered compound moistened with an inert liquid diluent. The tablets may optionally be coated or scored and may be formulated so as to provide slow or controlled release of the active ingredient therein.
  • the push-fit capsules can contain the active ingredients in admixture with filler such as lactose, binders such as starches, and/or lubricants such as talc or magnesium stearate and, optionally, stabilizers.
  • filler such as lactose, binders such as starches, and/or lubricants such as talc or magnesium stearate and, optionally, stabilizers.
  • the active compounds may be dissolved or suspended in suitable liquids, such as fatty oils, liquid paraffin, or liquid polyethylene glycols.
  • stabilizers may be added.
  • Dragee cores are provided with suitable coatings.
  • concentrated sugar solutions may be used, which may optionally contain gum arabic, talc, polyvinyl pyrrolidone, carbopol gel, polyethylene glycol, and/or titanium dioxide, lacquer solutions, and suitable organic solvents or solvent mixtures.
  • Dyestuffs or pigments may be added to the tablets or dragee coatings for identification or to characterize different combinations of active compound doses.
  • the compounds of the present invention may be formulated for parenteral administration by injection, e.g. as intraocular, intraveneous, subcutaneous, intramuscular, or intraarterial injection.
  • the injection may be administered by bolus injection or continuous infusion.
  • Formulations for injection may be presented in unit dosage form, e.g., in ampoules or in multi-dose containers, with an added preservative.
  • the compositions may take such forms as suspensions, solutions or emulsions in oily or aqueous vehicles, and may contain formulatory agents such as suspending, stabilizing and/or dispersing agents.
  • the formulations may be presented in unit-dose or multi- dose containers, for example sealed ampoules and vials, and may be stored in powder form or in a freeze-dried (lyophilized) condition requiring only the addition of the sterile liquid carrier, for example, saline or sterile pyrogen-free water, immediately prior to use.
  • sterile liquid carrier for example, saline or sterile pyrogen-free water
  • Extemporaneous injection solutions and suspensions may be prepared from sterile powders, granules and tablets of the kind previously described.
  • Formulations for parenteral administration include aqueous and non-aqueous (oily) sterile injection solutions of the active compounds which may contain antioxidants, buffers, bacteriostats and solutes which render the formulation isotonic with the blood of the intended recipient; and aqueous and non-aqueous sterile suspensions which may include suspending agents and thickening agents.
  • Suitable lipophilic solvents or vehicles include fatty oils such as sesame oil, or synthetic fatty acid esters, such as ethyl oleate or triglycerides, or liposomes.
  • Aqueous injection suspensions may contain substances which increase the viscosity of the suspension, such as sodium carboxymethyl cellulose, sorbitol, or dextran.
  • the suspension may also contain suitable stabilizers or agents which increase the solubility of the compounds to allow for the preparation of highly concentrated solutions.
  • the compounds may also be formulated as a depot preparation. Such long acting formulations may be administered by implantation (for example intraocular or subcutaneously or intramuscularly) or by intramuscular injection.
  • the compounds may be formulated with suitable polymeric or hydrophobic materials (for example as an emulsion in an acceptable oil) or ion exchange resins, or as sparingly soluble derivatives, for example, as a sparingly soluble salt.
  • compositions may take the form of tablets, lozenges, pastilles, or gels formulated in conventional manner.
  • Such compositions may comprise the active ingredient in a flavoured basis such as sucrose and acacia or tragacanth.
  • the compounds may also be formulated in rectal compositions such as suppositories or retention enemas, e.g., containing conventional suppository bases such as cocoa butter, polyethylene glycol, or other glycerides.
  • Compounds of the present invention may be administered topically, that is by non-systemic administration. This includes the application of a compound of the present invention externally to the epidermis or the buccal cavity and the instillation of such a compound into the ear, eye and nose, such that the compound does not significantly enter the blood stream.
  • systemic administration refers to oral, intravenous, intraperitoneal and intramuscular administration.
  • Formulations suitable for topical administration include liquid or semi-liquid preparations suitable for penetration through the skin to the site of inflammation such as gels, liniments, lotions, creams, ointments or pastes, and drops suitable for administration to the eye, ear or nose.
  • the amount of compound of formula (I) will generally be in the range of 0.001 to 10% weight/volume (%w/v). Preferred concentrations range from 0.1 to 5 %w/v.
  • Topical administration to the eye is given one to six times per day.
  • a typical formulation contains 0.1 - 5 % of compound of formula (I), 0.5 %w/v hydroxypropylmethylcellulose (HMPC), 0.8 %w/v sodium chloride, 0.28 %w/v sodium phosphate, 0.01 %w/v edetate disodium, 0.01 %w/v benzalkonium chloride. The pH is adjusted to 7.2 - 7.4. Purified water is added q.s.
  • Gels for topical or transdermal administration of compounds of the subject invention may comprise, generally, a mixture of volatile solvents, nonvolatile solvents, and water.
  • the volatile solvent component of the buffered solvent system may preferably include lower (Ci-C 6 ) alkyl alcohols, lower alkyl glycols and lower glycol polymers. More preferably, the volatile solvent is ethanol.
  • the volatile solvent component is thought to act as a penetration enhancer, while also producing a cooling effect on the skin as it evaporates.
  • the nonvolatile solvent portion of the buffered solvent system is selected from lower alkylene glycols and lower glycol polymers. Preferably, propylene glycol is used.
  • the nonvolatile solvent slows the evaporation of the volatile solvent and reduces the vapor pressure of the buffered solvent system.
  • the amount of this nonvolatile solvent component, as with the volatile solvent, is determined by the pharmaceutical compound or drug being used. When too little of the non-volatile solvent is in the system, the pharmaceutical compound may crystallize due to evaporation of volatile solvent, while an excess will result in a lack of bioavailability due to poor release of drug from solvent mixture.
  • the buffer component of the buffered solvent system may be selected from any buffer commonly used in the art; preferably, water is used.
  • Appropriate gelling agents can include, but are not limited to, semisynthetic cellulose derivatives (such as hydroxypropylmethylcellulose) and synthetic polymers, and cosmetic agents.
  • Lotions according to the present invention include those suitable for application to the skin or eye.
  • An eye lotion may comprise a sterile aqueous solution optionally containing a bactericide and may be prepared by methods similar to those for the preparation of drops.
  • Lotions or liniments for application to the skin may also include an agent to hasten drying and to cool the skin, such as an alcohol or acetone, and/or a moisturizer such as glycerol or an oil such as castor oil or arachis oil.
  • Creams, ointments or pastes according to the present invention are semi-solid formulations of the active ingredient for external application. They may be made by mixing the active ingredient in finely-divided or powdered form, alone or in solution or suspension in an aqueous or nonaqueous fluid, with the aid of suitable machinery, with a greasy or non-greasy base.
  • the base may comprise hydrocarbons such as hard, soft or liquid paraffin, glycerol, beeswax, a metallic soap, a mucilage; an oil of natural origin such as almond, corn, arachis, castor or olive oil, wool fat or its derivatives or a fatty acid such as steric or oleic acid together with an alcohol such as propylene glycol or a macrogel.
  • the formulation may incorporate any suitable surface active agent such as an anionic, cationic or non-ionic surfactant such as a sorbitan ester or a polyoxyethylene derivative thereof.
  • suitable surface active agent such as an anionic, cationic or non-ionic surfactant such as a sorbitan ester or a polyoxyethylene derivative thereof.
  • Suspending agents such as natural gums, cellulose derivatives or inorganic materials such as silicaceous silicas, and other ingredients such as lanolin, may also be included.
  • Drops according to the present invention may comprise sterile aqueous or oily solutions or suspensions and may be prepared by dissolving the active ingredient in a suitable aqueous solution of a bactericidal and/or fungicidal agent and/or any other suitable preservative, and preferably including a surface active agent.
  • Formulations for topical administration in the mouth include lozenges comprising the active ingredient in a flavored basis such as sucrose and acacia or tragacanth, and pastilles comprising the active ingredient in a basis such as gelatine and glycerine or sucrose and acacia.
  • the compounds according to the invention are conveniently delivered from an insufflator, nebulizer pressurized packs or other convenient means of delivering an aerosol spray.
  • Pressurized packs may comprise a suitable propellant such as dichlorodifluoromethane, trichlorofluoromethane, dichlorotetra-fluoroethane, carbon dioxide or other suitable gas.
  • the dosage unit may be determined by providing a valve to deliver a metered amount.
  • the compounds according to the invention may take the form of a dry powder composition, for example a powder mix of the compound and a suitable powder such as lactose or starch.
  • the powder composition may be presented in unit form, in for example, capsules, cartridges, gelatine or blister packs from which the powder may be with the aid of an inhalator or insufflator.
  • Preferred unit dosage formulations are those containing an effective dose, as herein below recited or an appropriate fraction thereof, of the active ingredient.
  • formulations of this invention may include other agents conventional in the art having regard to the type of formulation in question, for example those suitable for oral administration may include flavoring agents.
  • the compounds of the present invention may be administered via any route discussed above at a dose range for adult humans which is generally from 0.01 mg/kg/day to 60 mg/kg/day, more preferably from 0.01 mg/kg/day to 30 mg/kg/day, most preferably from 0.01 mg/kg/day to 15 mg/kg/day.
  • the amount of active ingredient that may be combined with the carrier materials to produce a single dosage form will vary depending upon the host treated and the particular mode of administration.
  • the compounds of the subject invention can be administered in various modes, e.g. orally, topically, or by injection.
  • the precise amount of compound administered to a patient will be the responsibility of the attendant physician.
  • the specific dose level for any particular patient will depend upon a variety of factors including the activity of the specific compound employed, the age, body weight, general health, sex, diets, time of administration, route of administration, rate of excretion, drug combination, the precise disorder being treated, and the severity of the indication or condition being treated.
  • the route of administration may vary depending on the condition and its severity.
  • This assay investigates cytotoxicity which is defined as the cell-killing property of a chemical compound, independent from the mechanisms of cell death.
  • the HepG2 hepatoblastoma cell line is one of the most common human cell lines for hepatotoxicity studies. Even though the cells lack a part of the metabolizing enzymes present in fresh hepatocytes, they have been shown to be a useful tool for studying the toxicity of hepatotoxins.
  • This assay measures metabolic activity of living cells using the WST-1 cell proliferation reagent (Roche Diagnostics). The tetrazolium salt WST-1 is cleaved to water soluble formazan by cellular enzymes. An expansion in the number of viable cells results in an increase in the overall activity of mitochondrial dehydrogenases in the sample.
  • This augmentation in enzyme activity leads to an increase in the amount of formazan dye formed, which directly correlates to the number of metabolically active cells in the culture.
  • the formazan dye produced by metabolically active cells is directly quantified in a scanning multiwell spectrophotometer by measuring the absorbance of the formazan dye solution between 420 and 480 nm. Healthy HepG2 cells, when maintained in culture, continuously divide and multiply over time. A toxic chemical, regardless of site and mechanism of action, will interfere with this process and result in the reduction of the growth rate reflected in the cell number.
  • Hep-G2 cells are seeded into a 96-well microplate and maintained in culture for 24 hours. They are then exposed to the test compound over a range of eight concentrations. After 24 hours exposure, the cells are incubated in presence of reagent WST-1 for 30 min before measuring the absorbance of the formazan dye formed. Cytotoxicity is expressed as a concentration dependent reduction of the conversion formazan dye formation due to a decrease in cell proliferation as compared to untreated cells.
  • the TC 50 Total Concentration 50%
  • the TC 50% values were calculated using the following formula:
  • Electrons donated from the citric acid cycle in form of NADH are transferred between complexes I, II and III of the respiratory chain.
  • mitochondrial membrane potential is generated through proton pumps in the mitochondrial inner membrane.
  • This electrochemical gradient across the inner mitochondrial membrane is used in healthy cells to provide the energy to drive mitochondrial ATP production. Consequently, cellular ATP levels are a good indicator of mitochondrial function.
  • this mode of ATP production is impaired and alternative modes of ATP production are utilized that can be associated with toxic byproducts (i.e. lactic acidosis due to increased anaerobic glycolysis).
  • Cells were treated with 0.1% (v/v) of compounds (10 mM in DMSO; final concentration: 10 ⁇ ) and incubated for 72 h at 37 °C, 5% C0 2 , and 90% rH. The number of cells was counted and after brief washing in PBS and collecting through centrifugation (5 min; 200 x g) the cells were lysed in a volume of 0.5 ml lysis solution (4 mM EDTA, 0.2% Triton X- 100) for 15 min.on ice and10 ⁇ of lysate was added into a white 96 well plate. In parallel, ATP standards (concentrations: 0, 1 , 2, 4, 6, 8, and 12 ⁇ in PBS) were also added into the 96 well plate.
  • the reaction was started by addition of 100 ⁇ reaction mix (300 ⁇ D-Luciferin, 5 ⁇ g/ml firefly luciferase, 75 ⁇ DTT, 25 mM HEPES, 6.25 mM MgCI 2) 625 ⁇ EDTA and 1 mg/ml BSA) and the luminescence signal was quantified in a multimode plate reader (Tecan M1000 plate reader; luminescence integration time: 100 ms). The concentration of cellular ATP normalized to cell number is calculated for each well and triplicate measurements are averaged. The ATP levels are given in Table 2.
  • Lipid peroxidation is a well defined mechanism of cellular damage in both animals and plants that occurs during aging and in some disease states. This process proceeds by a free radical chain reaction mechanism. It most often affects polyunsaturated fatty acids, because they contain multiple double bonds in between which methylene-CH2- groups possess especially reactive hydrogens. If not terminated fast enough, lipid peroxidation damages cellular membranes, affect membrane fluidity and also mitochondrial function. In addition, end products of lipid peroxidation may be mutagenic and carcinogenic. For instance, the reactive end product of lipid peroxidation, malondialdehyde, directly causes DNA damage.
  • BODIPY® (4,4-difluoro-3a,4adiaza-s-indacene) fluorophore is an effective tracer of lipid trafficking, as well as being useful general-purpose membrane probes.
  • BODIPY 581/591-C1 1 can be used to measure antioxidant activity in lipid environments by exploiting its loss of fluorescence upon interaction with peroxyl radicals.
  • Primary human fibroblasts C4 (GM04545, Coriell) (passage ⁇ 12) were seeded at a concentration of 2000 cells/ well into black 96 well plates and incubated for 72 hours in DMEM in the presence of 10 ⁇ test compound or DMSO only.
  • 0.1 ml freshly prepared dye solution (HBSS, containing BODIPY dye 1 :1000 from stock solution) was added and cells were returned to the incubator for 30 min. After 2 brief washes with 0.1 ml warmed PBS fluorescence was measured in 50 ⁇ PBS. Fluorescence for 4 individual areas per well were individually quantified at two wavelengths (Ex ⁇ 490, Em ⁇ 600; Ex 2 : 490, Em 2 : 530, bandwith 10nm, 50 flashes, 400Hz frequency, 20 [is integration time).
  • Complex II is an enzyme complex bound to the matrix face of the inner mitochondrial membranes. It consists of four subunits with several different enzymatic activities. One of these is the citric acid-cycle enzyme succinate dehydrogenase, which catalyzes the conversion from succinate to fumarate. In this reaction electrons are transferred from succinate to the prosthetic group FAD thus generating FADH 2 (Ackrell 2000). These electrons are then transferred from the reduced FADH 2 to ubiquinone, from ubiquinone to the reaction centers of complex III ( l II), and finally to the cytochrome c. During this electron translocation process, complex III pumps four protons from matrix to the intermembrane space.
  • SURFE2R SSM sensors were coated with inner mitochondrial membranes according to the standard protocols. Briefly, sensors were filled with 50 ⁇ . of SensorPrep A solution and incubated for 10-15 min. Afterwards the solution was removed, sensor were rinsed with deionized water three times dried in a stream of nitrogen gas and incubated for 15 min at room temperature to get rid of remaining solvents. 1.5 ⁇ _ of SensorPrep B1 solution were applied to the sensor and immediately covered with 50 ⁇ _ of the buffer (150 mM Na-gluconate, 30 mM Hepes pH 7.2/NMG, 10 mM MgCI2, 12.5 mM NaPi pH7.2, freshly added 0.2 mM DTT). Incubate the sensor for 15-60 min at 4°C.
  • the buffer 150 mM Na-gluconate, 30 mM Hepes pH 7.2/NMG, 10 mM MgCI2, 12.5 mM NaPi pH7.2, freshly added 0.2 mM DTT.
  • the biosensors were thawed immediately before the experiment and measured with the SURFE2R Workstation 50 or 500 devices.
  • the CII-CIII activity was studied by rapid exchange of a "non-activating" solution for an "activating" solution containing the 3 ⁇ oxidized cytochrome c. 2 s of non-activating buffer was followed by 1 s of activating buffer and then again 1 s non- activating buffer. Afterwards the sensor was rinsed 3 times with 1 ml_ non-activating buffer. A further activation with cytochrome c was performed after an incubation time of -1 1 min. Both buffers contained 1 mM succinate and 350 mg/L BSA to enhance the solubility of the test compounds.
  • Cll-lll For the activity of Cll-lll, the peak current (current amplitude) was evaluated.
  • the performed measurements of Cll-lll activities consisted of two parts. First the activity of Cll-lll was recorded in the absence of compound (instead 0.01 % DMSO) for about 50 min to obtain a constant CII-CIII activity (constant peak current amplitudes). Afterwards, a test compound ( ⁇ 4 ⁇ ) was supplied to the non-activating and the activating solutions and the Cll-lll activity was recorded for further -50 min (1 10 min in total). For each sensor, all peak currents were normalized to the mean of the activities after 24, 36 and 48 min.
  • n (t 0-110) 2.
  • the CII- CIII activity was recorded for additional -50 min (up to 160 min in total).
  • Lipids are normally broken down during mitochondrial beta oxidation of fatty acids (FA). Since the electron equivalents of lipid peroxidation are thought to be preferentially fed into the mitochondrial respiratory chain at the level of Complex II (Bruss et al. Am. J. Physiol. Edocrinol. Metab. 2010; 298:E108-E116), it is of importance to assess that the function of this complex is not altered by the treatment.
  • mice Male C57BI/6 mice were held under standard laboratory conditions (12 hours light per day, 22 ⁇ 2 °C, 40-60% humidity) with food and water available ad libitum. At the age of nine weeks, Compound IA (200 mg/kg, formulated in standard rodent chow) was administered p.o. for a period of three weeks. Vials containing 8 g food mash were administered to single-caged animals at the start of the dark cycle while allowing access to supplementary food ad libitum. After the treatment period, animals were sacrificed and the left heart ventricle was immediately excised and lysed for RNA extraction. RNA was purified following standard protocols.
  • Double-stranded cDNA was synthesized from 1.8 pg RNA via single-stranded cDNA reverse transcription using a Superscript II polymerase and T7-(N) 6 primers and subsequent double-strand cDNA synthesis using DNA polymerase 1. Following overnight in vitro transcription to generate cRNA, single-stranded cDNA was synthesized by reverse transcription using Superscript II, random primers and dUTP and thereafter cleaned from RNA templates. Samples were hybridized to the Affymetrix GeneChip® Mouse Exon 1.0 ST Arrays covering over one milllion exon clusters (Affymetrix, Santa Clara, CA, USA) according to instructions by Affymetrix.
  • mice Eight-week-old male C57BLJ6J mice were purchased from Janvier (France). After one week acclimatization period in the facility (12 hours light per day, 22 ⁇ 2 °C, 60% humidity), the animals were single-housed in cages with enriched environment (i.e. running wheels) and received a daily dose of 200 mg/kg Compound IA in the food as described above for microarray analysis. Portions which amounted to 75% of the daily calorie intake were supplemented with artificial sweetener for taste preference. Individual portions were stored at -20 °C and administered daily prior to the beginning of dark period. The portions for control animals were prepared identically with the exception of omitted Compound IA. Additionally, mice had access to ad libitum food. Body weight of animals and food intake from ad libitum pellets were measured three times a week over a period of four weeks. Body weight of the animals as well as cumulative food intake relative to body weight was used as endpoints.
  • Mitochondrial impairment directly influences cellular survival. Especially cells and tissues that display high level of energy consumption, such as neurons are especially vulnerable. Consequently, these cells and tissues are likely to be the most responsive to a strategy that targets mitochondrial function. We addressed this possibility by assessing the viability of the retinal ganglion cell line RGC-5, challenged with the mitochondrial complex I inhibitor rotenone, in the absence or presence of compounds.
  • RGC-5 cells were cultured under ambient conditions (37 °C, 5% C02, 90% humidity) in DMEM (1g/l glucose; 10% fetal bovine serum (FBS), Penicillin- Streptomycin-Glutamine (PSG)). RGC-5 cells will be seeded in DMEM (1g/l glucose; 2% FBS) into BD FalconTM cell culture plates. Before rotenone- induced complex I inhibition, the cells were pre-treated with Compound IA or vehicle. For Compound IA co-treatment with rotenone, new compound was added together with rotenone-containing cell culture media. After the rotenone exposure, the media was exchanged and replaced by Hanks' BSS for the 1 day post- incubation.
  • DMEM 1g/l glucose; 10% fetal bovine serum (FBS), Penicillin- Streptomycin-Glutamine (PSG)
  • FBS fetal bovine serum
  • PSG Penicillin- Streptomycin-Glutamine
  • the post-treatment media contained Compound IA or vehicle only.
  • cellular ATP content was analyzed using luminescence from ATP-dependent enzymatic oxidation of luciferin by luciferase.
  • RGC-5 cells were be washed with PBS and lysed in lysis buffer (4 mM EDTA, 0.2% Triton X-100) at room temperature.
  • ATP measurement buffer 25 mM HEPES pH 7.25, 300 ⁇ D-luciferin, 5 pg/ml firefly luciferase, 75 ⁇ DTT, 6.25 mM MgCI2, 625 ⁇ EDTA and 1 mg/ml BSA was combined with lysate to start the reaction.
  • Luminescence was quantified immediately using a multimode plate reader (Tecan M1000, Tecan iControl 1.6 software; Tecan Austria GmbH, Grodig, Austria). Effects on cell viability were defined as the percentage of compound-mediated change in cell viability relative to rotenone-induced reduction in cell viability. Data are presented as mean ⁇ SEM. Paired Student's t-test was used to compare non-normalized data. Statistical significance was set at p ⁇ 0.05( * ), p ⁇ 0.01 ( ** ) and p ⁇ 0.001 ( *** ) ⁇
  • Fig. 2 1 day-preincubation with Compound IA ( A) or propentophylline (PP)
  • This mouse model is used to assess the therapeutic potential of compounds in eye disorders characterized by mitochondrial dysfunction such as LHON, DOA, macular degeneration, retinopathy, and complex I deficiency. It is a widely accepted in vivo model based on single-eye intravitreal injection of the mitochondrial complex I inhibitor rotenone in the adult mouse. Intravitreal injection of rotenone induces neurotoxicity through mitochondrial complex I dysfunction in the retina which is the main molecular dysfunction associated with. The impact of oral pre-treatment with test compounds for 3 weeks is histologically assessed on retinal integrity at different time points after rotenone injection.
  • Histological analysis includes quantitative measurement of the retinal thickness (whole retina and individual layers), RGC apoptosis and cell death, oxidative stress, glutamine synthetase expression, and gliosis.
  • the non-injected eye is used as a within subject, i.e. intraindividual, control.
  • mice Male wild-type C57BU6J mice (7 weeks old, about 25 g body weight) are individually housed in Makrolon type II cages with standard bedding and free access to food and water under a regular 12-hours light-dark cycle (8 a.m. to 8 p.m.).
  • mice are treated once daily for 3 weeks with a dose range of the test compound (20 to 2000 mg/kg of body weight in CMC 0.5%) or with vehicle (CMC 0.5%) administered in diet (mixed 1 :1 with autociaved food powder supplemented with 10% sucrose; 5.5 g/day) or by gavage (p.o.; 10 ml/kg of body weight/day) prior to a single-eye intravitreous injection of rotenone (15 mM in DMSO, 1 ⁇ ) or DMSO vehicle (1 ⁇ ).
  • Mice are anesthetized (by inhalation of 1.5% to 2% isoflurane) and rotenone (or DMSO vehicle) is injected into the vitreous chamber of the right eye using a 10- ⁇ Hamilton syringe adapted with a small needle.
  • the needle tip is inserted into the superior hemisphere of the eye, at the level of the pars plana and with a 45° angle through the sclera.
  • the injection is performed over a period of 2 min and the needle is kept in place for an additional 3 min, after which it is gently removed.
  • mice Sterile surgical glue (Histoacryl, BRAUN/Aesculap AG, Germany) is used to seal the site of injection and a sterile antimicrobial ophtalmic ointment (Neosporin, GlaxoSmithKline, UK) is applied to the injected eye to avoid any infection.
  • a sterile antimicrobial ophtalmic ointment Neosporin, GlaxoSmithKline, UK
  • mice are then returned to their home cages where they are continuously exposed to the test compound (or vehicle) until sacrificed for histological analysis (1 and 7 days following rotenone injection). Briefly, mice are anesthetized by i.p.
  • ketamin/xylazin (2/1 , 200 ⁇ ) and subsequently perfused intracardiacally with a slolution of 4% paraformaldehyde in phosphate buffer (PB 0.1 M) for eye fixation.
  • the eye balls are removed, retinas are dissected, fixed for an additional 2 h at 4°C, incubated in PB 0.1 M and 30% sucrose overnight, frozen in optimal cutting temperature compound (O.C.T., Tissue-Tek, Miles Laboratories, Elkhart, IN, USA), sliced at 14 m, and collected onto glass slides for immunostaining. Immunostaining is performed accordingly to conventional method using multiple primary antibodies. Fluorescent-conjugated secondary antibodies and DAPI are used for visualization under a fluorescence microscope. All procedures are performed in accordance with the Swiss regulation and under a license approved by the "Kantonales Veterinaramt Basel-Land".
  • the histological data are expressed as % of sham (DMSO) injected control ⁇ SEM.
  • the RGC number is based on RGC cells / mm 2 on 1 day post-injection; the retinal thickness ( ⁇ ) is based on a 7 days post-injection; gliosis is based on relative fluorescence units (RFU) of GFAP-specific immunostaining on 7 days post-injection; glutamine-synthetase (GS) is based on relative fluorescence units (RFU) of GS-specific immunostaining on 1 day post-injection.
  • IA 400 means a pretreatment with Compound IA at 400 mg/kg
  • IA 2000 means a pretreatment with Compound IA at 2000 mg/kg.
  • Statistical significance relative to vehicle + rotenone group is p ⁇ 0.05 (*), p ⁇ 0.01 ( * *).
  • n is the number of retinas per group.
  • the histological data on 7 days post-injection is expressed as % of sham (DMSO) injected control ⁇ SEM.
  • the RGC number is based on RGC cells / mm 2 ; the retinal thickness is measured in ⁇ and gliosis is based on relative fluorescence units (RFU) of GFAP-specific immunostaining.
  • S within Table 6 means sham-injected (DMSO);
  • V means vehicle-treated;
  • R means rotenone-injected.
  • IA 200 defines a treatment with Compound IA at a concentration of 200 mg/kg; similiarily, IA 400 and IA 2000: define a treatment with Compound IA at 400 mg/kg and at 2000 mg/kg, respectively.
  • Statistical significance relative to vehicle + rotenone group is expressed as p ⁇ 0.05 ( * ).
  • n designates the number of retinas per group.
  • mice were allowed to habituate for 5 min to the experimental conditions before stripes were rotated alternately clockwise and counterclockwise, for 2 min in each direction and with an interval of 30 s between the two rotations.
  • the mice were recorded on a computer using a digital video camera mounted above the apparatus to subsequently score the number of head movements by manual counting. Head movements were scored only when the angular speed of the head turn corresponds to that of the drum rotation.
  • a second, blinded investigator conducted all assessments. Codes were broken upon completion of data acquisition by a third investigator. Each mouse was tested at different time points and the apparatus will be cleaned between mice. Data will be presented as mean ⁇ SEM. Paired Student's t-test and analysis of variance (ANOVA) will be used to compare non- normalized data. Statistical significance will be set at p ⁇ 0.05( * ), p ⁇ 0.01 ( ** ) and p ⁇ 0.001 ( *** ).
  • Table 7 Effect of idebenone pre-treatment on visual acuity in an in vivo mouse model for LHON.
  • Pharmacokinetic analysis of test compounds after oral administration aims to determine its bioavailability and clearance in the plasma and in the eye fluids (aqueous and vitreous humor).
  • the test compounds are quantified in the plasma and in the aqueous and vitreous humor after acute and repeated treatment (with different routes of administration).
  • the time-dependent concentration is then determined and pharmacokinetic parameters (C max , AUC 0 -t, t max ) are calculated.
  • mice Male wild-type C57BLJ6J mice (7 weeks old, about 25 g body weight) are individually housed in Makrolon type II cages with standard bedding and free access to food and water under a regular 12-hours light-dark cycle (8 a.m. to 8 p.m.). Mice receive single or daily repeated oral doses of the test compounds (ranging from 20 to 2000 mg/kg of body weight) or the vehicle administered though the diet or by gavage at the end of the light phase. The treatment can be followed by a washout period. Samples for pharmacokinetic analysis are taken at different time intervals following compound administration. Mice are anesthetized by 5% isofluran inhalation in an induction chamber and sacrificed by cervical dislocation. Blood is collected from the head cut for plasma extraction.
  • Eye balls are dissected out to collect aqueous and vitreous humor. Samples are snap frozen in liquid nitrogen and stored (-80°C) until analyzed by LC-MS/MS and accordingly to standardized procedures. All mouse procedures are performed in accordance with the Swiss regulation and under a license approved by the "Kantonales Veterinaramt Basel-Land".
  • idebenone compound IA
  • the pharmacokinetic profile of idebenone was assessed, following a single oral gavage dose to male mice. Following a single oral dose of 400 mg/kg idebenone concentrations in plasma, and vitreous and aqueous humors, generally reached a maximum at the first sampling time (15 min post-dose), suggesting rapid absorption and rapid uptake of idebenone into the eye (Table 8). Thereafter, concentrations of idebenone in plasma, and vitreous and aqueous humors generally declined over a 6 h post-dose period, suggesting a lack of sequestration of idebenone in the eye.
  • the ratio (vitreous humor /plasma and aqueous humor/plasma) appeared to be independent of the time post dose, consistent with a lack of accumulation of idebenone in the eye.
  • the overall extent of exposure to idebenone in the vitreous humor, as measured by AUC 0 -6h. represented about 2 % of that observed in plasma (vitreous/plasma ratio; Table 8).
  • the extent of exposure to idebenone in the aqueous humor represented about 3 % of that observed in plasma (aqueous/plasma ratio; Table 8).
  • the apparent terminal half-life (t 1 2 ) of idebenone in plasma was 1.70 h, respectively (Table 8). (The apparent terminal half-lifes t 1 2 of idebenone could not be estimated in vitreous humor and in aqueous humor, due to limited data).
  • a simple oral dosing results in sufficient levels of Compound IA in the eye to exert its beneficial effects on mitochondrial diseases like LHON, autosomal dominant optic atrophy (DOA), macular degeneration, glaucoma, retinopathy, cataract, optic disc drusen (ODD), mitochondrial myopathy, encephalomyopathy, lactic acidosis, stroke-like symptoms (MELAS), myoclonic epilepsy with ragged red fibers (MERRF), myoneurogenic gastrointestinal encephalomyopathy (MNGIE), Kearns-Sayre syndrome, CoQ10 deficiency, or mitochondrial complex deficiencies (1-5, CPEO) as all these diseases are associated with an ophthalmological phenotype.
  • mitochondrial diseases like LHON, autosomal dominant optic atrophy (DOA), macular degeneration, glaucoma, retinopathy, cataract, optic disc drusen (ODD), mitochondrial myopathy, encephalomyopathy, lactic acidosis, stroke-like symptoms
  • Compound IA exhibits linear kinetics of absorbtion into the eye fluids, since the ratio (vitreous humor /plasma and aqueous humor/plasma) is independent of the dose used. Furthermore, there was no accumulation of Compound IA in the eye, since the ratio (vitreous humor /plasma and aqueous humor/plasma) is independent of dosing duration or time post- dosing. There was also no sequestration of Compound IA found in the eye.

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US10722880B2 (en) 2017-01-13 2020-07-28 Cellular Research, Inc. Hydrophilic coating of fluidic channels
US11584728B2 (en) 2019-10-04 2023-02-21 Stealth Biotherapeutics Inc. Compositions and methods for the prevention and/or treatment of mitochondrial disease, including Friedreich's ataxia
US12037350B2 (en) 2020-04-03 2024-07-16 Stealth Biotherapeutics Inc. Compositions and methods for the prevention and/or treatment of mitochondrial disease, including Friedreich's ataxia

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WO2018078922A1 (ja) * 2016-10-24 2018-05-03 国立大学法人福井大学 白内障の予防剤、治療剤、およびこれらを製造するためのｈａｔ阻害剤の使用
MX2019008542A (es) 2017-01-18 2019-11-05 Schlumberger Technology Bv Sistema de circulacion ininterrumpida para mantener la presion de fondo de pozo.
WO2021211436A1 (en) * 2020-04-13 2021-10-21 Travecta Therapeutics Pte. Ltd. Idebenone compounds

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US10722880B2 (en) 2017-01-13 2020-07-28 Cellular Research, Inc. Hydrophilic coating of fluidic channels
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US12037350B2 (en) 2020-04-03 2024-07-16 Stealth Biotherapeutics Inc. Compositions and methods for the prevention and/or treatment of mitochondrial disease, including Friedreich's ataxia

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